Emotional disorders in the postpartum period develop under the influence of several factors. The woman's body experiences stress during childbirth, the hormonal background changes sharply, a new social role of the mother appears, and the restructuring of life and relationships within the family takes place. There are many reasons for the formation of depression, the most common are:
The origin and development of postpartum depression is considered within the framework of polyetiological theory. In accordance with this approach, emotional disorder is formed under the combined influence of three factors: heredity, specific physiological changes, and psychosocial characteristics. The overwhelming majority of mothers with depression have a constitutional predisposition - a weak unstable type of higher nervous activity, decreased production of neurotransmitters responsible for emotions and performance (serotonin, dopamine, norepinephrine). Specific physiological mechanisms underlying the disorder are a sharp change in hormonal levels (termination of pregnancy), pain and other discomfort associated with the process of childbirth. A common psychosocial factor that provokes depression is a change in the role of a woman, a reduction in the time for habitual pleasant activities, the need for round-the-clock care of an infant.
Common manifestations of depressive disorder include depression of mood, unreasonable changeable emotions, tearfulness, irritability, and decreased motivation for any activity. Sleep disturbances are manifested by insomnia or excessive sleepiness. Appetite becomes increased, up to gluttony, or completely disappears. Subjectively, women experience a sense of their own worthlessness, accuse themselves of inability to perform the functions of a mother, in a lack of affection and love for the child. They experience an inability to concentrate on household chores, they cannot make decisions on their own in everyday matters. They move away from the usual communication, from contacts with close people. In severe depression, thoughts of harming yourself and your child arise.
By the nature of the course, several forms of postpartum depression are distinguished. With the neurotic variant of the disorder, there is an exacerbation of negative experiences that manifested themselves during pregnancy and childbirth , for example, provoked by the threat of miscarriage. A characteristic symptom is increased anxiety. Patients are in constant expectation of a bad event (illness, death of a child, family breakdown). Tension is manifested by outbursts of irritability and dysphoria. Women become hot-tempered, sometimes aggressive. In severe cases, panic attacks , hypochondria , headaches and chest pains, attacks of tachycardia , sweating, shortness of breath are formed. The condition gradually deteriorates during the day, by the evening there is mental and physical exhaustion - loss of strength, weakness, apathy, inconsolable crying.
In depression with neurotic components, somatic disorders develop as the main symptoms. Emotional experiences are rejected by the patient as unacceptable, shameful. Insomnia, decreased appetite, and weight loss come to the fore. Often there is an obsessive fear of harming the child, over-control of his condition. This disorder is based on the impact of traumatic situations before and during pregnancy.
Another type of depression is melancholy with a delusional component. Psychomotor retardation and feelings of guilt are key symptoms. Women are acutely experiencing imaginary insolvency, they call themselves "bad mothers." Overvalued ideas that realize self-accusation, self-deprecation, and suicidal tendencies prevail. This form of the disorder can develop into a more serious illness - postpartum psychosis.
The most common form of depression among young mothers is the lingering form. It proceeds in disguise, often perceived by patients as fatigue, blues, adaptation to the child's regime and the role of the mother. The development of symptoms is slow, so referrals to specialists are extremely rare. Women experience weakness, exhaustion, which is mistakenly associated with the experience of childbirth, blood loss. Tearfulness and irritability increase, night awakenings for feeding a newborn are difficult to endure. Caring for a child is painful, but a critical attitude towards one's own experiences remains.
It is always important to know how the problem manifests itself at the very beginning of its development. The first sign of a painful condition is by no means sudden mood swings. An often subtle symptom is a harbinger of a complex disorder. Postnatal depression is characterized by glycogenesis. This is the sensation of a sweet, sugary taste in the mouth. It can occur already in the first days after the birth of the child. The likelihood of developing full-fledged postpartum depression in this case is more than 90%.
Another subtle symptom leading to a pathological nervous breakdown is smearing vaginal discharge. Common lochiae are common in women in labor, but low daily blood loss can have a negative impact on the emotional sphere. Coupled with family troubles associated with an understandable unwillingness to intimacy, there is a feeling of hopelessness and uselessness, and further prospects seem dim. Only family support and medication for iron deficiency will help protect against depression.
Any form of depression in the mother reduces the level of emotional closeness between her and the baby. Aloofness, lack of love and affection prevent the formation of a sense of basic security, which later serves as the basis for mental illness in the child. A woman's concentration on her own experiences often leads to a lag in the mental development of the baby (lack of stimulation, organization of games). The most severe complications occur with untreated melancholic depression. Ideas of self-blame and pathological fears develop into persistent delusional concepts, attempts at suicide and injury to a child - postpartum psychosis develops.
How long postnatal depression lasts is hard to say. With rational help, the disease can be avoided, and the duration of the reduced mood background will be minimal. The diagnosis is formally established if signs of anxiety disorder persist for more than seven days. The following factors affect the duration of depression:
With insufficient family support, lack of sexual intercourse, poor health of the baby, the level of "happy" hormones decreases sharply. This provokes a long duration of depression and even a transition to a chronic form. An equally negative role is acquired by the existing organic pathology of the brain and the associated delirium. In these cases, even attempts at suicide are possible, which are usually not characteristic of postpartum depressive episodes.
Postpartum depression is most often formed in the first months after childbirth, the duration of the disorder is individual: from several weeks to several years. The initial examination is carried out by a psychiatrist ; in addition, a consultation with a psychologist and a gynecologist (endocrinologist) may be prescribed. With an integrated approach to diagnosis, the following methods are used:
Help for mothers with depressive disorder is determined by its severity: in a mild form, it is enough to consult a psychologist or psychotherapist ; with moderate symptoms, psychotherapy sessions and drug correction are recommended ; with severe disease, hospitalization, intensive drug therapy and psychotherapy are required. The whole range of medical and psychological support includes:
It is absolutely unacceptable to experience the problem on your own with the ineffectiveness of home treatment. Depression and despondency will only progress, which will lead to dire consequences. With ongoing depression, medication is required, which is prescribed exclusively by a doctor. Antidepressants and tranquilizers form the basis of therapeutic correction.
In parallel, vitamins, hypnotics and drugs that stimulate the brain are prescribed. Usually, the treatment process takes place at home, but in severe cases, especially when attempting suicide or delusional disorders, hospitalization is indicated. Of course, natural feeding in such cases will have to be excluded.
Postpartum depression can be successfully treated, so the prognosis is often good. Prophylaxis should be started several months before delivery. It is recommended to master relaxation techniques - breathing exercises, gymnastics, auto-training (self-hypnosis). Regular exercises should become a habit, since when depression approaches, there is no strength for new beginnings. It is worth discussing with the husband, mother, mother-in-law in advance the willingness to provide assistance (volume, frequency, duration). In the daily and weekly plan, time must be allocated for activities that bring pleasure, joy, and improve self-esteem - dancing, massage, spa treatments , meeting with friends.
It is imperative to fight a depressive mood. The question of how to get rid of the disease on your own is always acute in any family, since it is initially difficult to make a decision about referring to a specialist. The main condition is to improve the quality of life and improve the family microclimate. The following will help in getting rid of depression:
Communication with loved ones plays the most important role in how to get out of postpartum depression. This is a kind of psychological training that helps to escape from the difficult postnatal life. If the mood continues to decline, the further prospect of non-drug treatment is solely with a specialist. It is necessary to contact a psychotherapist for individual or group sessions.